ABSTRACT
Adults age 65 and older have high rates of suicide, despite recent efforts to reduce the suicide rate in this population. One suicide prevention strategy with burgeoning empirical support is safety planning; however, there is a lack of information and resources on safety planning for older adults to support uptake of this evidence-based practice in clinical settings where older adults are commonly seen. Safety plans can address risk factors for suicide in older adults, including social isolation, physical illness, functional limitations, and use of highly lethal means. Safety plans also promote relevant protective factors, including increasing use of coping strategies, social support, and help-seeking. Clinicians may encounter challenges and barriers to safety planning with older adults. This paper describes a collaborative, creative approach to safety planning that is relevant and useful for this vulnerable population. Using two case examples, we illustrate how to engage older adults in safety planning, including ways to minimize barriers associated with the aging process.
Subject(s)
Suicide Prevention , Adaptation, Psychological , Aged , Female , Humans , Male , Risk Factors , Social SupportABSTRACT
Purpose of Study: To develop a structured observational tool, the Resident-centered Assessment of Interactions with Staff and Engagement tool (RAISE), to measure 2 critical, multi-faceted, organizational-level aspects of person-centered care (PCC) in nursing homes: (a) resident engagement and (b) the quality and frequency of staff-resident interactions. Design and Methods: In this multi-method psychometric development study, we conducted (a) 120 hr of ethnographic observations in one nursing home and (b) a targeted literature review to enable construct development. Two constructs for which no current structured observation measures existed emerged from this phase: nursing home resident-staff engagement and interaction. We developed the preliminary RAISE to measure these constructs and used the tool in 8 nursing homes at an average of 16 times. We conducted 8 iterative psychometric testing and refinement cycles with multi-disciplinary research team members. Each cycle consisted of observations using the draft tool, results review, and tool modification. Results: The final RAISE included a set of coding rules and procedures enabling simultaneously efficient, non-reactive, and representative quantitative measurement of the interaction and engagement components of nursing home life for staff and residents. It comprised 8 observational variables, each represented by extensive numeric codes. Raters achieved adequate to high reliability with all variables. There is preliminary evidence of face and construct validity via expert panel review. Implications: The RAISE represents a valuable step forward in the measurement of PCC, providing objective, reliable data based on systematic observation.
Subject(s)
Aging/psychology , Attitude of Health Personnel , Behavior Observation Techniques/methods , Homes for the Aged , Nursing Homes , Patient Participation , Quality of Life , Aged , Aged, 80 and over , Female , Geriatric Assessment/methods , Humans , Male , Patient Participation/methods , Patient Participation/psychology , Professional-Patient Relations , Psychometrics/methods , Reproducibility of ResultsABSTRACT
OBJECTIVES: To explore the implications of limited English proficiency (LEP) for disparities in health status and healthcare service use of older Latino and Asian immigrants. DESIGN: Cross-sectional analysis of existing secondary data. SETTING: The 2007 California Health Interview Survey. PARTICIPANTS: Latino and Asian immigrants aged 60 and older (n=1,745) were divided into three language proficiency groups: older adults who have LEP, are proficient in English but also speak another language at home (EP), and speak English only (EO). MEASUREMENTS: Sociodemographic characteristics, health status, health service use, and barriers to service use were compared. RESULTS: Older Latino and Asian immigrants with LEP tended to have poorer self-rated health and higher psychological distress than the EP and EO groups. They were also less likely than the EP and EO groups to use health services and more likely to experience barriers to service use (e.g., difficulty understanding written information at the doctor's office). CONCLUSION: Older Latinos and Asians with LEP are at higher risk for poor physical and mental health outcomes and inadequate health care. Healthcare systems should consider strategies to address the language needs of older immigrants to reduce the effect of linguistic disparities on access to care and ultimately to improve health status for these vulnerable populations.
Subject(s)
Emigrants and Immigrants , Health Services/statistics & numerical data , Health Status , Hispanic or Latino , Language , Aged , Aged, 80 and over , Asian People , California , Cross-Sectional Studies , Female , Humans , Male , Mental Health , Middle Aged , Socioeconomic FactorsABSTRACT
Visual object recognition is often assumed to be insensitive to changes in retinal position, leading to theories and formal models incorporating position-independent object representations. However, recent behavioral and physiological evidence has questioned the extent to which object recognition is position independent. Here, we take a computational and physiological perspective to review the current behavioral literature. Although numerous studies report reduced object recognition performance with translation, even for distances as small as 0.5 degrees of visual angle, confounds in many of these studies make the results difficult to interpret. We conclude that there is little evidence to support position-independent object recognition and the precise role of position in object recognition remains unknown.
